Laparoscopic Anti-Reflux (GERD) Surgery Patient Information from SAGES

How the Surgery is Performed

How is Laparoscopic Anti-Reflux Surgery Performed?antireflux_page_5

  • Laparoscopic anti-reflux surgery (commonly referred to as Laparoscopic Nissen Fundoplication) involves reinforcing the “valve” between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus – much the way a bun wraps around a hot dog.
  • In a laparoscopic procedure, surgeons use small incisions (1/4 to 1/2 inch) to enter the abdomen through trocars (narrow tube-like instruments). Carbon dioxide gas is used to temporarily expand the abdomen, giving the surgeon room to see and work.
  • The laparoscope, which is connected to a tiny video camera, is inserted through the small incision, giving the surgeon a magnified view of the patient’s internal organs on a television screen.
  • The entire operation is performed “inside” using narrow instruments that are passed through the trocars.
What Happens if the Operation Cannot Be Performed Completely by the Laparoscopic Method?

In a small number of patients the laparoscopic method is not feasible because of the inability to visualize or handle the organs effectively. Factors that may increase the possibility of converting to the “open” procedure may include obesity, a history of prior abdominal surgery causing dense scar tissue, or bleeding problems during the operation. The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather sound surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.

Laparoscopic Anti-reflux Surgery

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What to Expect if You Choose to Have Laparoscopic and Anti-Reflux Surgery

What Should I Expect after Surgery?

  • Patients are encouraged to engage in light activity while at home after surgery, and should avoid heavy lifting or strenuous activity for a short period of time which will be determined by your surgeon.
  • Post operative pain is generally mild although some patients may require prescription pain medication for a short period of time.
  • Anti-reflux medication is usually not required after surgery.
  • Most surgeons temporarily modify patient’s diet after surgery beginning with liquids followed by gradual advance to solid foods. You should ask your surgeon about dietary restrictions immediately after the operation.
  • You will probably be able to get back to your normal activities within a short amount of time. These activities include showering, driving, walking up stairs, lifting, working and engaging in sexual intercourse.
  • Call and schedule a follow-up appointment within 2 weeks after your operation.

Are There Side Effect to This Operation?

Studies have shown that the vast majority of patients who undergo the procedure are either symptom free or have significant improvement in their GERD symptoms.

Long-term side effects to this procedure are generally uncommon.

  • Some patients develop temporary difficulty swallowing immediately after the operation. This usually resolves within one to three months after surgery.
  • Occasionally, patients may require a procedure to stretch the esophagus (endoscopic dilation) or rarely re-operation.
  • The ability to belch and or vomit may be limited following this procedure. Some patients report stomach bloating.
  • Rarely, some patients report no improvement in their symptoms. Reflux symptoms can also return months to years after the procedure.

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Brought to you by:

SOCIETY OF AMERICAN GASTROINTESTINAL AND ENDOSCOPIC SURGEONS (SAGES)
11300 West Olympic Blvd., Suite 600
Los Angeles, CA 90064
Tel:
(310) 437-0544
Fax:
(310) 437-0585
E-Mail:
publications@sages.org
Revised:
March 1, 2015
This brochure is intended to provide a general overview of a surgery. It is not intended to serve as a substitute for professional medical care or a discussion between you and your surgeon about the need for a surgery. Specific recommendations may vary among health care professionals. If you have a question about your need for a surgery, your alternatives, billing or insurance coverage, or your surgeons training and experience, do not hesitate to ask your surgeon or his/her office staff about it. If you have questions about the operation or subsequent follow up, discuss them with your surgeon before or after the operation.